Looking for Hope: Preventing Mother-to-Child Transmission of HIV in Lesotho
Sarah Epstein and Clelia Barbadoro, UNICEF
In the little known African kingdom of Lesotho almost one in every four adults is living with HIV. This small country, landlocked within the borders of South Africa, has the third highest HIV prevalence rate in the world. Its hospitals and clinics report that one in three pregnant women in antenatal care is HIV positive, meaning that every year thousands of children risk being born with HIV, passed from mother to child during pregnancy or birth.
The Government of Lesotho, with the support of UNICEF, has increased the number of clinics and hospitals offering Prevention of Mother to Child Transmission (PMTCT) services that reduce the chances of babies being born with HIV . In these clinics, every pregnant mother is tested for HIV, given counseling and advice and if necessary, put on a lifesaving anti retroviral (ARV) drug regime. Within eight hours of the birth, trained midwives ensure the newborn is given a dose of the ARV Nevirapine to prevent HIV transmission. Enhanced PMTCT services now also offer the baby a dose of AZT to further reduce chances of transmission.
Post birth the mother is given advice and support to follow an appropriate breast-feeding regime which significantly reduces the chances of passing the virus through breast-milk. By offering such services the nurses, counselors and other health care professionals in these hospitals and clinics are increasing the numbers of babies born free from HIV in Lesotho.
Despite ongoing efforts from the Government and UNICEF however, today only 20 percent of all HIV positive women in the country can access PMTCT. As a result, one in ten of all babies are born with HIV in Lesotho. In richer countries of the world, it is a very different scenario. Rates of mother-to-child transmission of HIV have dropped to less than one in every 50 babies thanks to good availability of PMTCT services. But in poorer countries like Lesotho, funding remains limited. Globally, the figure remains at less than 11 percent of women accessing PMTCT, meaning that almost every minute of every day a child is born with HIV somewhere in the world. For these babies chances of survival are slim; without appropriate care and treatment, more than half will die before their second birthday.
If PMTCT services were rolled out to all clinics in Lesotho and globally, there's a chance that all babies could be born free from HIV. In the words of one young woman, Mathakane Metseng, "I believe that the prevention of HIV from mother to child is very important because we need a new generation in this country who are not HIV positive. I am looking for hope that within five years there will be no more HIV positive babies born in Lesotho. By then all of the women should have tested themselves and, if they are positive, have the knowledge about how to prevent the virus passing to their babies. That is my dream."
